Why is interoperability still incomplete?

Despite decades of effort, health care interoperability remains an unfinished project — and physicians feel the consequences daily. When patient data can't move seamlessly between systems, doctors are left piecing together incomplete medical histories, ordering redundant tests and making decisions without a full clinical picture. A recent physician sentiment survey found that 95% of physicians said getting the right clinical information at the right time is very important to them, yet only 28% said sending and receiving patient data across different electronic health record systems works well. Faxing remains a major way to share health care information in medical practices.

The fragmentation stems from a mix of technical, governance and competitive barriers. Progress is being made, however. The 21st Century Cures Act prohibits information blocking by health care providers, and enforcement has intensified — hospitals that unreasonably impede data sharing could lose 75% of their Medicare annual payment update. The CMS Advancing Interoperability and Prior Authorization Final Rule, with full API requirements due by January 2027, is also pushing payers and providers toward greater data exchange compliance. But experts agree significant gaps remain.

Sandra Johnson, senior vice president at CliniComp, spoke with Medical Economics about interoperability challenges and what needs to change to solve them.